title: Changes in brain natriuretic peptide level as a predictor of AF recurrence after electrical cardioversion.
abstract: OBJECTIVE
  Early recurrence of atrial fibrillation (AF) is common after electrical cardioversion (ECV). Accurate prediction of AF recurrence might allow more selective use of ECV and the targeted use of antiarrhtyhmic therapy in those at highest risk of recurrence.
  
  
  METHODS
  We have screened consecutive patients attending for cardioversion of AF and recruited those without valvular heart disease, heart failure or permanent pacemakers. All patients underwent echocardiography and measurement of serum BNP levels within 24 hours before ECV. Measurement of BNP was repeated at 1, 7, 30 and 90 days after ECV and an ECG recorded on each occasion.
  
  
  RESULTS
  We have screened 24 consecutive patients. Five were excluded. All 19 study subjects were succesfully cardioverted to sinus rhythm. AF recurred in nine cases. Recurrence of AF was associated with AF duration, left atrial size, the presence of hypertension and the BNP level before cardioversion. BNP fell significantly after cardioversion. The BNP level after cardioversion was not associated with AF recurrence.
  
  
  CONCLUSIONS
  Even in persons without valvular heart disease or heart failure, an elevated level of BNP predicts recurrence of AF after ECV. The level to which BNP falls after cardioversion is not predictive of AF recurrence.
authors.affiliation: Department of Cardiology, Tor Vergata University, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ruggiero
authors.forename: L
authors.initials: L
authors.lastname: Santini
authors.forename: M M
authors.initials: MM
authors.lastname: Gallagher
authors.forename: L P
authors.initials: LP
authors.lastname: Papavasileiou
authors.forename: V
authors.initials: V
authors.lastname: Romano
authors.forename: F
authors.initials: F
authors.lastname: Canziani
authors.forename: S
authors.initials: S
authors.lastname: D'annibale
authors.forename: F
authors.initials: F
authors.lastname: Romeo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000628:therapy*; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence
chemical_list: D020097:Natriuretic Peptide, Brain